The hyperimmunoglobulin E syndrome is a primary immunodificiency disorder characterized by recurrent staphylococcal infections and markedly elevated serum IgE level. Clinical features are coarse face and severe infections of the skin-furunculosis or chronically pruritic dermatitis and sinopulmonary tract infection from infancy by coagulase positive Staphylococcus aureus, or Candida albicans etc. The patients's serum IgE level is elevated but the basic immunologic pathogenesis not fully understood. We have experienced a case of hyperimmunoglobulin E syndrome in a 26/12-year-old who had suffered from recurrent staphylococcal pneumonias and abscesses and chronically pruritic dermatitis from 1 month of age with elevated serum IgE level. A brief review of the related literature is presented.
Abscess ; Candida albicans ; Coagulase ; Dermatitis ; Immunoglobulin E ; Pneumonia, Staphylococcal ; Staphylococcal Infections ; Staphylococcus aureus

PURPOSE: The purpose of this study is to identify factors associated with the stages of change in medication adherence in patients with hypertension. METHODS: Participants were 323 patients with hypertension. Sociodemographic/medication-related characteristics, stages of change, processes of change, self efficacy and decisional balance were self-administered. RESULTS: Stages of change were significantly different according to gender, age, job and living arrangement. A multinominal logistic regression analysis has revealed that gender, age, living arrangement, self-liberation, and self-efficacy were significantly associated with the precontemplation stage. Age and self-liberation were significantly associated with the contemplation stage. Gender, age, living arrangement, and self-liberation were significantly associated with the preparation stage. Gender and helping relationship were significantly associated with the action stage. This model explained 52.0% of the stages of change in medication adherence. CONCLUSION: The tailored intervention strategies based on the stages of change may be needed for improving medication adherence in patients with hypertension.
Humans ; Hypertension ; Logistic Models ; Medication Adherence ; Residence Characteristics ; Self Efficacy

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is associated with metabolic syndrome including insulin resistance, hypertension, dyslipidemia, central obesity, type 2 diabetes, and cardiovascular disease. In NAFLD, insulin resistance plays an important role in the progression of liver damage. In this study, we evaluated insulin resistance, plasma adiponectin, hepatic steatosis, and their association in adults with normal liver transaminase concentrations. METHODS: We analyzed 111 subjects, aged over 20 years old, who visited the Health Management Center at Chung-Ang University Hospital between May 2006 and August 2006. They had neither history nor clinical evidence of diabetes, cardiovascular or liver disease. They were divided into three groups by the degree of hepatic steatosis based on ultrasound findings. Anthropometric parameters were measured and blood samples were drawn after eight hours of fasting. RESULTS: Hepatic steatosis had a positive correlation with body mass index, waist circumference, blood pressure, triglycerides, HOMA-IR, and QUICKI. Moreover, it had a negative correlation with high-density lipoprotein cholesterol and adiponectin. Triglycerides, Adiponectin, and QUICKI were independent variables in predicting the degree of hepatic steatosis. CONCLUSION: This finding suggests that triglycerides and plasma adiponectin are independent predictors of hepatic steatosis in adults with normal liver transaminase concentrations.
Adiponectin ; Adult ; Aged ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Dyslipidemias ; Fatty Liver ; Humans ; Hypertension ; Insulin Resistance ; Lipoproteins ; Liver ; Liver Diseases ; Obesity, Abdominal ; Plasma ; Triglycerides ; Waist Circumference

No abstract available.
Acidosis*

No abstract available.
Pressure Ulcer*

PURPOSE: Tacrolimus (FK506) is a new potent immunosuppressive agent which has been used as a primary immunosuppressive agent and rescue therapy for refractory rejection in kidney transplantation. In vitro, on a molecular basis, tacrolimus is 10 to 100 times more potent than cyclosporine. Complications associated with tacrolimus are similar to those seen in cyclosporine, including nephrotoxicity. An early marker of tacrolimus-induced nephropathy is tubular vacuolization, whereas long-term administration of tacrolimus is associated with striped interstitial fibrosis and arteriolar hyalinosis. However, morphological changes and pathogenesis of fibrosis in chronic tacrolimus-induced nephropathy remain poorly understood. Transforming growth factor (TGF)-beta1 has been implicated in the fibrosis of a number of chronic diseases of the kidney and other organs. This study was designed to clarify the ultrastructural changes of tacrolimus-induced nephropathy, and to evaluate the relationship between tacrolimus- induced nephropathy and expression of TGF-beta1. METHODS: Male ICR mice received tacrolimus daily at a dose of 2.5 mg/kg by intraperitoneal route for 12 weeks and sacrified 1, 4, 8, 10, and 12 weeks after the initiation of the study, respectively. The kidneys were removed, the cortex is carefully dissected from the medulla, and the tissues are processed for evaluation by light microscopy, electron microscopy, immunohistochemistry and RT-PCR for RNA analysis. RESULTS: Characteristic histological changes of tacrolimus-induced nephropathy were peritubular capillary and intraglomerular capillary congestions, vacuolizations of the tubular epithelium, pericapillary focal fibrosis, and tubular atrophy. Tacrolimus- treated kidneys had a progressive increase in the expression of TGF-beta1, especially in the glomerular and interstitial capillary endothelial cells and atrophied tubular epithelial cells. TGF-beta1 mRNA is expressed persistently in tacrolimus- treated mice for 12 weeks. CONCLUSION: It can be concluded that TGF-beta1 may be involved in the fibrogenesis in the tacrolimus-induced nephropathy.
Animals ; Atrophy ; Capillaries ; Chronic Disease ; Cyclosporine ; Endothelial Cells ; Epithelial Cells ; Epithelium ; Estrogens, Conjugated (USP) ; Fibrosis ; Humans ; Immunohistochemistry ; Kidney ; Kidney Transplantation ; Male ; Mice ; Mice, Inbred ICR ; Microscopy ; Microscopy, Electron ; RNA ; RNA, Messenger ; Tacrolimus ; Transforming Growth Factor beta1 ; Transforming Growth Factors

No abstract available.
Ciprofloxacin* ; Mycobacterium tuberculosis* ; Mycobacterium*

No abstract available.
Chylothorax* ; Chylous Ascites*

To compare the differences between hemodialysis and essential hypertension patients and its affecting factors of left ventricular hypertrophy and left ventricular systolic dysfucntion in patients with hemodialysis, M-mode and two dimensional echocardiography were performed in 77 essential hypertension without azotemia and 78 chronic renal failure patients receiving maintenance hemodialysis. M-mode measurement including LV mass (192.56+/-63.6g vs 300.01+/-95.99g, P=0.000), r/th (radius/LV thickness, 4.41+/-0.97 vs 4.74+/-1.0, P=0.039), LV dimemsion and fractional shortening (4.68+/-0.6 vs 5.63+/-0.97, P=0.000, 30.0+/-19.7% vs 36.6+/-97%, P=0.000 respectively) showed more severe eccentric LV hypertrophy and LV dysfunction in patients with hemodialysis than those of essential hypertension. Using Pearson correlation in hemodialysis patients, Interdialytic weight gain was positively correlated with LVEDD (r=0.318, P=0.005). In addition to the determinant, serum PTH level was negatively (r=-0.344, P=0.002) and Kt/V (r= 0.0487, P=0.003) was positively correalated with systolic function. The hypertension and dialysis duration, patient's age, had no relationship with LV function and mass in this study. In Conclusion, LV hypertrophy and LV systolic dysfunction occur more frequently in hemodialysis patients than in essential hypertension patients. And the LV systolic dysfunction, which is acutally related with the patient's quality of life, was partially explained by serum parathyroid level and Kt/V. But additional laboratory and prospective clinical studies are needed to further elucidate the mechanisms involved in the development of LVH and LV impairment in hemodialysis patients.
Azotemia ; Dialysis ; Echocardiography* ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Quality of Life ; Renal Dialysis* ; Ventricular Dysfunction, Left ; Weight Gain

BACKGROUND: Erythema induratum was first described by Bazin in association with tuberculosis. However, the tuberculous cause of this entity has been questioned by several authors and gradually, the concept of nontiiberculous nodular vasculitis has been accepted OBJECTIVE: The purpose of this study is to document the clinicopathologic features of erythema induratum. METHODS: We investigated clinical and histopathological findings of 31 patient with erythema induratum who showed positive tuberculin hypersensitivity reaction or had active associated tuberculosis. RESULTS: The ages of the 31 patients(M7: F24) ranged from 13 to 66 years(mean 37.1 years). All patients displayed recurrent crops of tender, painful, violaceous noudules or plaques. Most lesions were present on the legs, but they also occurred on the thighs, feet, buttocks, and forearms. The skin lesions evolved for several weeks and healed with scarring and residual pigmentation. Histological examination revealed lobular or septolobular panniculitis with varying cornbinations of granulomatous inflammaticn, primary vasculitis and necrosis in most biopsies. Twenty two patients were treated with isoniazid alone and the remaining 9 patients received combination anti tuberculous treatment. Relapses were encountered in 4 patients who received isoniazid alone or stopped the medicationrgainst medical advice. CONCLUSION: A diagncisis of erythema induratum should be rendered in the presence of relevant clinicopathologic features, strong positive Mantoux test reaction, and good therapeutic response to antituberculous treatme,it. A full course of combination antituberculous therapy is indicated to achieve a cure of the skin lesions of erythema induratum.
Biopsy ; Buttocks ; Cicatrix ; Erythema Induratum* ; Erythema* ; Foot ; Forearm ; Humans ; Hypersensitivity ; Isoniazid ; Leg ; Necrosis ; Panniculitis ; Pigmentation ; Recurrence ; Skin ; Thigh ; Tuberculin ; Tuberculosis ; Vasculitis